Justine Elliot (Richmond, Australian Labor Party, Minister for Ageing) Share this | Hansard source

in reply—I am very pleased to have the opportunity to sum up debate on the Aged Care Amendment (2008 Measures No. 2) Bill 2008. Recent data released in September 2008 by the Australian Bureau of Statistics shows one in four Australians will be aged 65 or over by 2056. Australia now has the world’s second-longest life expectancy rates, after the Japanese. Women in the wheat belt of Western Australia and on Queensland’s Sunshine Coast have one of the longest life expectancy rates in the world. These figures suggest why caring for our ageing population is one of the major challenges facing our nation this century. That requires careful planning, adequate funding and comprehensive safeguards to ensure the protection of our older Australians.

The debate here has highlighted the importance of achieving a balance between protecting the needs and rights of individual frail aged persons entering aged-care homes and the long-term viability of the aged-care sector. For too long there has been a lack of national leadership on this very, very important issue, but the Rudd government takes this responsibility very, very seriously. The Aged Care Amendment (2008 Measures No. 2) Bill 2008 provides the most extensive changes to the aged-care regulatory regime in 10 years and is also the first broad change to the Aged Care Act under this government. The bill is part of a range of measures that address current inadequacies in legislation and enhance protection for residents. This includes ensuring that any accommodation bonds or like payments paid by older Australians for entering into aged care are fully protected under the Accommodation Bond Guarantee Scheme.

In the decade since the Aged Care Act came into effect, the aged-care industry has seen a significant increase in investment by large corporate entities. We have seen aged care grow from a cottage industry with a typical one site, one service set-up to a very complex sector with very intricate financial and legal arrangements and, in many cases, with dozens of operations. The regulatory framework must keep pace with the shift in business practices to ensure scrutiny of those pulling the financial strings and to ensure that, regardless of the corporate structure adopted, the relevant protections and provisions apply to aged-care providers.

This government has recognised that a considered response is needed for these major areas of change if we are successfully to meet the future challenges of our ageing population. The bill before us will better protect residents and will promote public confidence in the aged-care industry. Under the new arrangements, regulatory scrutiny will apply to those pulling the financial strings, who may not be currently considered as key personnel. This change will not include all leaders within the organisation unless they are actively involved in making financial or managerial decisions which will affect the executive decisions of the aged-care service.

Under these new arrangements, providers will need to identify those pulling the strings, as the approved provider is in the best position to identify these specific persons. A prescriptive approach was not practical for this measure, given the complexity and diversity of some of the modern organisational structures and roles within aged care. Under the new arrangements, church leaders, for example, who do not involve themselves in the executive decisions of aged-care services will not be included, as the department will only need to be notified of those who should be accountable. This record of related entities will be considered when making decisions about approvals to ensure a sound assessment of a company’s record in service delivery and of its suitability to be approved to deliver care in the future. Aged-care providers will not be able to avoid accountability through sophisticated business structures.

We have also made changes to the regulations surrounding accommodation bonds held by the aged-care sector. This ensures that comprehensive consumer safeguards are in place to protect residents’ funds. The Accommodation Bond Guarantee Scheme will equitably cover bonds and like payments and those bonds held by operators even if they lose their approved provider status. We have also responded to the calls from consumers to reduce aged-care assessment waiting times. This will achieve greater efficiencies through streamlined assessments and the reduction of red tape.

Two specific measures have also been included in this package by amending the principles. The first one requires notification to the Department of Health and Ageing if residents have been reported to the police as missing. The second one extends the police check requirement to restrict people with serious convictions from working in aged-care homes regardless of whether they are supervised or unsupervised. These changes are very important and directly address the safety of residents in our nursing homes.

I would like to now take the opportunity to address some of the matters raised by the member for McPherson. Firstly, I would like to acknowledge that the opposition essentially supports the amendments that are contained within this bill. I would like to respond to concerns raised about section 22 of the act in relation to high and low care. Those who were in the House 11 years ago may recall that with a stroke of a pen the former Prime Minister reintroduced the high and low care divide without going back to clarify the operation within the Aged Care Act. This has resulted in the issue that the member discussed. As stated, the Rudd government is committed to a considered approach to policy changes for aged care. The government has undertaken to review the implementation of the aged-care funding instrument after 18 months. This review will include its interface with aged-care assessments. This review will be conducted in a measured way to ensure sound outcomes for providers and aged-care recipients.

Another issue raised was the reporting of missing residents. To set the record straight, requiring that the department be notified when a resident has been reported to the police as missing will not restrict the basic human rights of older Australians. Nor will it restrict the freedom of movement of residents. A notification of the department will only be required when the approved provider has decided that a person is unaccountably missing and it is sufficiently concerned that it has notified police. The department’s response to the notification will be proportionate to the risk posed to the residents of the particular service. For example, there is likely to be no follow-up if the missing resident turns up having spent the day with family or friends. However, if a resident is reported as missing from a dementia ward and the provider’s explanation of the context indicates that there may have been some inadequate monitoring processes in place, the department’s response will be one of concern for the safety of all similar residents of that service.

The member for McPherson also raised concerns about amendments to section 65 of the act, which in the past has required the department to consider the desirability of deterring future noncompliance when imposing sanctions on an aged-care service. Indeed, these amendments clarify the current intent, purpose and power of the legislation. There is nothing new in this particular section. The changes will simply alleviate confusion and reflect past and current practice rather than expanding the range of matters taken into account. What should be noted is how rarely the department needs to impose sanctions. Currently, sanctions are enforced for 14 services out of a total of nearly 3,000 aged-care homes across the nation. Precompliance activity is generally sufficient to educate, encourage and assist providers to address areas of noncompliance and natural justice steps are part of this process. The compliance process only commences when the provider has not adequately responded to precompliance activities or where the degree of risk for care recipients requires stronger actions by the department. The compliance process is designed to ensure that noncompliance is remedied without delay and that care recipients do not remain at risk.

Finally, let me be very clear that there will no surprises for providers in the amended aged-care principles. Changes in the principles are consequential to and flow on from the act. The changes accurately reflect the policy intention outlined in previous consultation and explanatory material and in discussions with stakeholders.

Before I close, I would like to thank all of those who have been directly or indirectly involved in the development of this reform package. Insights offered through consultations with those in the aged-care industry and consumer representative groups have helped us to identify the best means by which to improve the system and provide further protection for the 170,000 older Australians living in our nation’s nearly 3,000 aged-care homes. These changes complement the government’s record funding of more than $41.6 billion over four years to support aged and community care. Indeed, within residential care, on average the government is providing record funding of $41,500 per resident each year. These changes will increase consumer confidence and maintain the level of investment within aged care. I commend the bill to the House.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.

Ordered that the bill be reported to the House without amendment.

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